Forms & Documents

All the forms and documents you need to submit a claim via mail, learn more about your policy, and more.

Standard Claims

pdf • 133 KB

pdf • 288 KB

pdf • 230 KB

Health Insurance

pdf • 545 KB

pdf • 852 KB

pdf • 818 KB

pdf • 805 KB

pdf • 722 KB

pdf • 886 KB

pdf • 111 KB

pdf • 146 KB

pdf • 235 KB

Travel Insurance

pdf • 841 KB

pdf • 947 KB

pdf • 222 KB

pdf • 790 KB

Group Benefits

pdf • 281 KB

pdf • 539 KB

pdf • 340 KB

pdf • 346 KB

pdf • 159 KB

pdf • 174 KB

pdf • 203 KB

pdf • 253 KB

pdf • 457 KB

Disability Claims

Please note: six forms are required to submit a Disability benefits claim.

Refer to the Employer and Employee Guides below for more information.

pdf • 150 KB

pdf • 148 KB

pdf • 121 KB

pdf • 460 KB

pdf • 195 KB

pdf • 104 KB

pdf • 583 KB

pdf • 174 KB

Critical Illness Claims

pdf • 191 KB

pdf • 545 KB

pdf • 178 KB

Life & Accidental Death & Dismemberment

pdf • 107 KB

pdf • 176 KB

pdf • 267 KB

Provider Forms

Forms & Documents

Standard Claims

Standard Health Claim

Standard Dental Claim

Out-of-Province Claim (Travel Insurance)

Student Accident Claim

Accidental Dental Pre-Authorization/Claim

Health Insurance

Personal Health Plan Brochure

Retiree Health Plan Brochure

Personal Health Plan Application

Blue Choice® Policy

Conversion Policy

Guaranteed Acceptance Policy

Retiree Plan Policy

Term Life & Critical Illness Optional Benefit Policy

Pre-Authorized Payment Agreement

Coordination of Benefits

Travel Insurance

Travel Plans Brochure

Single-Trip and Multi-Trip Annual Travel Policy

3-in-1 Package

3-in-1 Annual Package

Top-Up Travel Policy

Visitors to Canada Travel Insurance Policy

THIA Consumer Brochure

Travel Insurance Guide for Expectant Mothers

Group Benefits

Employee Change Form

Blue Essentials Brochure

Custom Group Benefits Brochure

Second Opinion® Brochure

Pre-Authorized Debit Agreement

Direct Deposit Authorization

Prescription Drug Special Authorization Form

Chronic Weight Management Special Authorization Form

Special Authorization & EDS Guide

Disability Claims

Employer’s Guide: Assisting an Employee

Employee’s Guide: Submitting a Claim

Disability Benefit Forms

Employer’s Statement: Application for Benefits

Employer: Job Description

Employee’s Statement: Application for Benefits

Employee: Education & Work History

Initial Disability Insurance Medical Statement

Direct Deposit Authorization

Critical Illness Claims

Application for Critical Condition Benefits

Application for Group Critical Condition Benefits

Attending Physician’s Statement Form

Life & Accidental Death & Dismemberment

Life Insurance Benefit Claim

Application for Terminal Illness Benefits

Accidental Dismemberment Claim

Proof of Death Physicians Statement

Provider Forms

Provider Direct Deposit Authorization

Quick Reference for Extended Health and Vision Providers

Frequently Asked Questions for Extended Health and Vision Providers

Quick Reference Guide for Dental Providers

Quick Reference Guide for Pharmacy Providers